Các yếu tố ảnh hưởng đến biên độ vận động khớp gối sau mổ thay khớp gối toàn phần

Abstract

Introduction: Range of motion after total knee arthroplasty is an important clinical outcome. Decreasing range of motion can lead to limit activity level as well as patient satisfaction. This study sought to determine the factors affecting range of motion after total knee arthroplasty.

Patients and methods: The retrospective descriptive of 50 patient (54 knees) were operated for total knee arthroplasty from 10/2016 to 10/2019.

Results: The average follow-up time was 24 months (12-36 months). The postoperative average range of motion was 108,6  7,6, 100% patients were more than 90 and there are no cases that loss of extention.

Conclusion: The preoperative knee deformity, compliance with rehabilitation procedures and surgical technique are the most influential factors.

Keywords: Knee range of motion, total knee arthroplasty.

References

1. Laubenthal K.N., Smidt G.L., and Kettelkamp D.B. (1972). A quantitative analysis of knee motion during activities of daily living. Phys Ther, 52(1), 34–43.
2. Patel D.V., Ferris B.D., and Aichroth P.M. (1991). Radiological study of alignment after total knee replacement. Short radiographs or long radiographs?. Int Orthop, 15(3), 209–210.
3. Rogers B.A., Thornton-Bott P., Cannon S.R., et al. (2006). Interobserver variation in the measurement of patellar height after total knee arthroplasty. J Bone Joint Surg Br, 88(4), 484–488.
4. Factors Affecting Flexion after Total Knee Arthroplasty | Request PDF. ResearchGate.
5. Kim J.-H. (2013). Effect of Posterior Femoral Condylar Offset and Posterior Tibial Slope on Maximal Flexion Angle of the Knee in Posterior Cruciate Ligament Sacrificing Total Knee Arthroplasty. Knee Surg Relat Res, 25(2), 54.
6. Goldstein W.M., Raab D.J., Gleason T.F., et al. (2006). Why posterior cruciate-retaining and substituting total knee replacements have similar ranges of motion. The importance of posterior condylar offset and cleanout of posterior condylar space. J Bone Joint Surg Am, 88 Suppl 4, 182–188.
7. K#nig C., Sharenkov A., Matziolis G., et al. (2010). Joint line elevation in revision TKA leads to increased patellofemoral contact forces. J Orthop Res Off Publ Orthop Res Soc, 28(1), 1–5.
8. Johal P., Williams A., Wragg P., et al. (2005). Tibio-femoral movement in the living knee. A study of weight bearing and non-weight bearing knee kinematics using “interventional” MRI. J Biomech, 38(2), 269–276.
9. Banks S., Bellemans J., Nozaki H., et al. (2003). Knee motions during maximum flexion in fixed and mobile-bearing arthroplasties. Clin Orthop, (410), 131–138.
10. Dennis D.A., Komistek R.D., Stiehl J.B., et al. (1998). Range of motion after total knee arthroplasty: the effect of implant design and weight-bearing conditions. J Arthroplasty, 13(7), 748–752.

Tóm tắt

Đặt vấn đề: Biên độ vận động khớp gối sau thay khớp gối toàn phần là một kết quả lâm sàng quan trọng. Giảm biên độ vận động gối dẫn đến giảm khả năng vận động cũng như sự hài lòng của người bệnh. Nghiên cứu này tìm hiểu các yếu tố ảnh hưởng đến biên độ sau thay khớp gối.

Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả hồi cứu 50 người bệnh  (54 khớp gối) được thay khớp gối toàn phần do thoái hoá khớp gối từ 10/2016 đến 10/2019.

Kết quả: Thời gian theo dõi trung bình 24 tháng (12-36 tháng). Biên độ vận động gối trung bình sau mổ là 108,6  7,6, 100 % có biên độ trên 90 và không có trường hợp nào mất duỗi.

Kết luận: Biến dạng gối trước mổ và mức độ tuân thủ qui trình phục hồi chức năng là những yếu tố ảnh hưởng nhiều nhất.

Từ khóa: Biên độ vận động gối, thay khớp gối toàn phần.

Tài liệu tham khảo

1. Laubenthal K.N., Smidt G.L., and Kettelkamp D.B. (1972). A quantitative analysis of knee motion during activities of daily living. Phys Ther, 52(1), 34–43.
2. Dennis D.A., Komistek R.D., Stiehl J.B., et al. (1998). Range of motion after total knee arthroplasty: the effect of implant design and weight-bearing conditions. J Arthroplasty, 13(7), 748–752.
3. Factors Affecting Flexion after Total Knee Arthroplasty | Request PDF. ResearchGate.
4. Patel D.V., Ferris B.D., and Aichroth P.M. (1991). Radiological study of alignment after total knee replacement. Short radiographs or long radiographs?. Int Orthop, 15(3), 209–210.
5. Rogers B.A., Thornton-Bott P., Cannon S.R., et al. (2006). Interobserver variation in the measurement of patellar height after total knee arthroplasty. J Bone Joint Surg Br, 88(4), 484–488.
6. Kim J.-H. (2013). Effect of Posterior Femoral Condylar Offset and Posterior Tibial Slope on Maximal Flexion Angle of the Knee in Posterior Cruciate Ligament Sacrificing Total Knee Arthroplasty. Knee Surg Relat Res, 25(2), 54.
7. Goldstein W.M., Raab D.J., Gleason T.F., et al. (2006). Why posterior cruciate-retaining and substituting total knee replacements have similar ranges of motion. The importance of posterior condylar offset and cleanout of posterior condylar space. J Bone Joint Surg Am, 88 Suppl 4, 182–188.
8. Kưnig C., Sharenkov A., Matziolis G., et al. (2010). Joint line elevation in revision TKA leads to increased patellofemoral contact forces. J Orthop Res Off Publ Orthop Res Soc, 28(1), 1–5.
9. Johal P., Williams A., Wragg P., et al. (2005). Tibio-femoral movement in the living knee. A study of weight bearing and non-weight bearing knee kinematics using “interventional” MRI. J Biomech, 38(2), 269–276.
10. Banks S., Bellemans J., Nozaki H., et al. (2003). Knee motions during maximum flexion in fixed and mobile-bearing arthroplasties. Clin Orthop, (410), 131–138.